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Abnormal (Dysfunctional) Uterine Bleeding

Pratha Muthiah, MPH, MD Reviewed 05/2023
 


BASICS

DESCRIPTION

  • Abnormal uterine bleeding (AUB) is uterine bleeding that is irregular in quantity, frequency, or duration 

  • May be acute or chronic (occurring >6 months)

  • The International Federation...

DIAGNOSIS

Most valuable in diagnosis and determining etiology is history 

HISTORY

  • Menstrual history: onset, severity (quantified by pad/tampon use, presence and size of clots), timing of bleeding (unpre...

TREATMENT

GENERAL MEASURES

NSAIDs (naproxen sodium 500 mg BID, mefenamic acid 500 mg TID, ibuprofen 600 to 1,200 mg/day) 
  • Decreases amount of blood loss and pain compared with placebo

  • “Surgical” approach...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Once stable from acute management, recommend follow-up evaluation in 4 to 6 months for further evaluation. 

Patient Monitoring

Women treated with estrogen or OCPs s...

REFERENCES

1
Committee on Practice Bulletins—Gynecology. Practice Bulletin No. 128: diagnosis of abnormal uterine bleeding in reproductive-aged women. Obstet Gynecol.  2012...

ADDITIONAL READING

SEE ALSO

  • Dysmenorrhea; Menorrhagia (Heavy Menstrual Bleeding)

  • Algorithm: Abnormal Uterine Bleeding

CODES

ICD10

  • N93.9 Abnormal uterine and vaginal bleeding, unspecified

  • N93.8 Other specified abnormal uterine and vaginal bleeding

SNOMED

  • 44991000119100 Abnormal uterine bleeding

CLINICAL PEARLS

  • AUB is irregular uterine bleeding that occurs in the absence of pregnancy or pathology, making it a diagnosis of exclusion.

  • Anovulation accounts for 90% of AUB.

  • EMB should be performed i...

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